ANTHONY DOUGLAS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125078443

License Status

CANCELLED

Business

Title

First Name

ANTHONY

Last Name

DOUGLAS

Business Name

ANTHONY DOUGLAS MD

Original Issue Date

06/24/2021

Effective Date

06/24/2021

Expiration Date

06/23/2024

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

04/01/2021